5 - Cognition PEDS - Down's syndrome

3 Students with moderate cognitive impairment (IQ of 50-55) have difficulty with functional reading and arithmetic calculations. The student can perform simple manual skills, such as copying information from the board, learning safe and healthy habits, and communicating with classmates.

A 10-year-old child has moderate cognitive impairment. With which activity would a teacher expect the child to need help? 1 Copying information from the board 2 Learning safe and healthy habits 3 Performing arithmetic calculations 4 Communicating with classmates

1 One of the characteristics of Down syndrome is a short, broad neck. These children have an impaired immune system and are at risk for spinal cord compression. Physical features such as long and thin fingers, short and thin lips, and broad and long nose are all common in a normal child and do not indicate any abnormality.

A week-old newborn is assessed for body weight, birth marks, and height. The birth weight is lower than what it should be for height. Which physical feature of the newborn makes the nurse conclude that the newborn is affected by Down syndrome? 1 Short and broad neck 2 Long and thin fingers 3 Short and thin lips 4 Broad and long nose

4 The diagnosis of cognitive impairment includes subaverage intellectual functioning and deficits in adaptive skills, including an onset before age 18. IQ is only one component of the diagnosis of cognitive impairment. The onset of the deficit must be before age 18 to meet the diagnosis of cognitive impairment.

The diagnosis of cognitive impairment is based on the presence of: 1 intelligence quotient (IQ) of 75 or less. 2 IQ of 70 or less. 3 subaverage intellectual functioning, deficits in adaptive skills, and onset at any age. 4 subaverage intellectual functioning, deficits in adaptive skills, and onset before 18 years of age.

3, 4, 5 Loss of established motor skill and bowel and bladder control indicate spinal cord compression and must be reported immediately. The child with Down syndrome may have persistent neck pain caused by spinal cord compression. These children do not have impaired pain sensation. Children with Down syndrome are not aggressive. Loss of impulse control is not seen in such children.

The nurse is assessing a child with Down syndrome. What findings in the child should alert the nurse to report to the health care provider immediately? Select all that apply. 1 Loss of pain sensation 2 Loss of impulse control 3 Loss of established motor skill 4 Loss of established bowel control 5 Loss of established bladder control

1 Newborns with Down syndrome have joint hyperflexibility and low muscle tone. This can make it difficult to hold the newborn because he or she can go limp like a rag doll. This makes it difficult for the parents to embrace and provide warmth to their newborn. This may make parents feel that the newborn is not bonding with them, but difficulty holding the child does not indicate impaired bonding between the child and parents. Inability to understand the child's needs and nonverbal communication indicates undeveloped bonding. Asking the parents whether they are more apprehensive does not answer their question. It is also a closed-ended question, which is not therapeutic communication. Telling the parents they need to see a counselor is not appropriate. They just need support and teaching.

The nurse is assessing a newborn with Down syndrome. The newborn's parent tells the nurse, "We are having a hard time holding our baby. We didn't have this hard of a time with our other children." What would be the nurse's best response? 1 "Children with Down syndrome have lower muscle tone." 2 "This happens in some children because of undeveloped bonding." 3 "Are you more apprehensive because your child has Down syndrome?" 4 "You should see a counselor to help you cope with your child's condition."

3, 5 Maternal age more than 35 years increases the risk of having babies with Down syndrome. Down syndrome is caused by the presence of an extra autosomal chromosome. Down syndrome is not caused by a mutation of chromosomes. Advanced paternal age is not a risk factor for Down syndrome. There is no extra sex chromosome in children with Down syndrome.

The nursing instructor is explaining the risk factors and pathogenesis of Down syndrome to a group of nursing students. What information should the nurse include in the explanation? Select all that apply. 1 It is caused by a mutation of chromosomes. 2 It is more likely to occur if the paternal age is more than 35 years. 3 It is more likely to occur if the maternal age is more than 35 years. 4 It is caused by acquisition of an extra sex chromosome. 5 It is caused by acquisition of an extra autosomal chromosome.

3 Behavior modification with positive reinforcement is effective in children with cognitive impairment. Discipline is essential in assisting the child in developing boundaries. Positive behaviors and desirable actions should be reinforced. Most children with cognitive impairment will not be able to understand the reason for the physical punishment; consequently behavior will not change as a result of the punishment.

The parents of a cognitively impaired child ask the nurse for guidance with discipline. The nurse's best response is: 1 "Discipline is ineffective with cognitively impaired children." 2 "Discipline is not necessary for cognitively impaired children." 3 "Behavior modification is an excellent form of discipline." 4 "Physical punishment is the most appropriate form of discipline."